New School

Task-sharing approaches that train non-specialist providers (NSPs), people without specialized clinical training, are increasingly utilized to address the global mental health treatment gap. This review consolidates findings from peer reviewed articles on the impact of task-sharing mental health interventions on NSPs at the individual, family and community level. Studies that highlighted facilitators, barriers and recommendations for improving the experiences of NSPs were also included in the review. Fifteen studies, conducted across eight countries, met the inclusion criteria. Seven studies were conducted in Sub-Saharan Africa, six in South and Southeast Asia and two studies were conducted in high-income countries in Europe. Benefits for NSPs included personal application of mental health skills, elevated community status and increased social networks. Challenges include burnout, lack of career progression and difficult workplace environments. Findings indicate that while there were many positive impacts associated with NSPs’ work, challenges need to be addressed. Safety and harassment issues reported by female NSPs are especially urgent. Supervision, certifications, increased salaries and job stability were also recognized as significant opportunities. We recommend future intervention studies to collect data on the impact of intervention delivery on NSPs. Research is also needed on the impact of various supervision and health systems strategies on NSPs.

Introduction Compared to their exclusively gay/lesbian or heterosexual identifying peers, young people identifying as bisexual+ (e.g. bisexual, pansexual, asexual, queer or questioning) are at elevated risk for suicidal ideation (SI) and attempts (SA). The present study aimed to establish whether the prevalence of, and psychosocial risk factors for, SI and SA vary as a function of sexual identity. Methods Young adults ( N = 274; 18–29 years old) were recruited via online crowdsourcing. They completed questionnaires assessing adverse childhood experiences (ACEs), emotion dysregulation, impulsivity, depression symptoms and lifetime history of SI and SA. Spearman correlations, Kruskal‐Wallis H ‐tests and binomial logistic regression models were used. Results No variable was associated with SI. Bisexual+ individuals reported greater SA than the heterosexual group, though statistically similar to the gay/lesbian group. A similar pattern emerged for ACEs. The bisexual+ group reported greater depression symptoms than the gay/lesbian group. Impulsivity and emotion dysregulation did not vary by sexual identity. Controlling for these psychosocial and sociodemographic variables did not alter results: bisexual+ individuals were almost three times more likely to report SA than heterosexual individuals, OR = 2.93 95% CI [1.16, 7.44]; gay/lesbian and heterosexual individuals had a statistically similar likelihood of reporting SA, OR = 1.09, 95% CI [0.27, 4.37]. Conclusion This is the first study to establish that young adults identifying as bisexual+ are at greater risk for SA after controlling for well‐established psychosocial correlates; this was not the case for SI. Further work is needed to establish the aetiology of this risk.

Importance Pediatric posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder, yet a comprehensive network meta-analysis examining psychological interventions is lacking. Objective To synthesize all available evidence on psychological interventions for pediatric PTSD in a comprehensive systematic review and network meta-analysis. Data Sources PsycINFO, MEDLINE, Web of Science, and PTSDpubs were searched from inception to January 2, 2024, and 74 related systematic reviews were screened. Study Selection Two independent raters screened publications for eligibility. Inclusion criteria were randomized clinical trial (RCT) with at least 10 patients per arm examining a psychological intervention for pediatric PTSD compared to a control group in children and adolescents (19 years and younger) with full or subthreshold PTSD. Data Extraction and Synthesis PRISMA guidelines were followed to synthesize and present evidence. Two independent raters extracted data and assessed risk of bias with Cochrane criteria. Random-effects network meta-analyses were run. Main Outcome and Measures Standardized mean differences (Hedges g ) in PTSD severity. Results In total, 70 RCTs (N = 5528 patients) were included. Most RCTs (n = 52 [74%]) examined trauma-focused cognitive behavior therapies (TF-CBTs). At treatment end point, TF-CBTs ( g , 1.06; 95% CI, 0.86-1.26; P < .001), eye movement desensitization and reprocessing (EMDR; g , 0.86; 95% CI, 0.54-1.18; P < .001), multidisciplinary treatments (MDTs) ( g , 0.88; 95% CI, 0.53-1.23; P < .001), and non–trauma-focused interventions ( g , 0.95; 95% CI, 0.62-1.28; P < .001) were all associated with significantly larger reductions in pediatric PTSD than passive control conditions. TF-CBTs were associated with the largest short-term reductions in pediatric PTSD relative to both passive and active control conditions and across all sensitivity analyses. In a sensitivity analysis including only trials with parent involvement, TF-CBTs were associated with significantly larger reductions in pediatric PTSD than non–trauma-focused interventions ( g , 0.35; 95% CI, 0.04-0.66; P = .03). Results for midterm (up to 5 months posttreatment) and long-term data (6-24 months posttreatment) were similar. Conclusions and Relevance Results from this systematic review and network meta-analysis indicate that TF-CBTs were associated with significant reductions in pediatric PTSD in the short, mid, and long term. More long-term data are needed for EMDR, MDTs, and non–trauma-focused interventions. Results of TF-CBTs are encouraging, and disseminating these results may help reduce common treatment barriers by counteracting common misconceptions, such as the notion that TF-CBTs are harmful rather than helpful.

On the 8th of September, 2022, the world paused as the BBC announced the death of Queen Elizabeth II. After 70 years on the throne, the longest-reigning British monarch had died aged 96. The Queen’s death immediately became a global media event that would eventually culminate in the state funeral broadcasted live and followed online worldwide. While many legacy media maintained the classical ceremonial mode of reporting the media event, the narratives and visuals on social media instantaneously challenged and re-narrated the ‘official’ media event dramaturgy. Through digital media ethnography of the media event, unfolding live in both legacy media and on social media platforms, this article demonstrates how diverse social media publics reacted to the legacy media narratives. Special emphasis is placed on the coverage of and the reactions to three parts of the event on BBC and on Twitter: (1) breaking news of the Queen’s death, (2) the Lying-in-State and (3) the State Funeral. The article concludes with a reflection of how the performances of live participation on social media created diverse dramaturgies and how those dramaturgies spoke to very different publics and consequently created a variety of possibilities to interpret the event and its meaning in history.

With the deepening of globalization, market boundaries are becoming increasingly blurred, and the importance of small and medium-sized enterprises (SMEs) as an indispensable part of the market is becoming more prominent. SMEs play an irreplaceable role in promoting economic growth, increasing employment, fostering market integration, and driving technological innovation. However, in the complex and ever-changing market economy, SMEs face significant challenges in securing financing. This article examines the root causes of these financing difficulties and proposes a series of practical and feasible solutions through theoretical analysis. It can be concluded that the current challenges faced by SMEs in financing include tight bank loan quotas, limited collateral, internal management issues, and asymmetric market information. At the same time, this article also proposes solutions such as optimizing government policies and improving the capabilities of SMEs.

Paranoia (believing others intend harm) and excess teleological thinking (ascribing too much purpose) are non-consensual beliefs about agents. Human vision rapidly detects agents and their intentions. Might paranoia and teleology have roots in visual perception? Using displays that evoke the impression that one disc (‘wolf’) is chasing another (‘sheep’), we find that paranoia and teleology involve perceiving chasing when there is none (studies 1 and 2) — errors we characterize as social hallucinations. When asked to identify the wolf or the sheep (studies 3, 4a, and 4b), we find high-paranoia participants struggled to identify sheep, while high-teleology participants were impaired at identifying wolves — both despite high-confidence. Both types of errors correlated with hallucinatory percepts in the real world. Although paranoia and teleology both involve excess perception of agency, the current results collectively suggest a perceptual distinction between the two, perhaps with clinical import.

Although early experiences with primary caregivers have been recognised to play a significant role in individuals’ attachment relationships, little is known about adoptees’ attachment trajectories once placed within their respective adoptive families. This study aims to address this by investigating how attachment representations might be explained by early predictors including childhood attachment representations and other pertinent pre-placement variables. In early childhood, the Story Stem Assessment Profile (SSAP) is used to capture these representations, whilst in adolescence, an attachment-orientated interview (Friends and Family Interview; FFI) is employed. The sample here consisted of 35 early adoptees, placed before 12 months of age, and 35 maltreated, late-adoptees, placed between four and nine years old. Regression models were statistically significant for three out of four FFI constructs ( Security, Disorganisation, Coherence), though most of these effects were driven by IQ. When exploring the late adoptees alone, all regression models were significant in explaining variance in adolescent attachment, with SSAP Defensive Avoidance and Abuse as the strongest predictors. When examining the early adoptees alone, only two models were statistically significant, with most of these effects from IQ. These findings add to current knowledge on the role of childhood variables in predicting attachment and suggest potential areas to improve adoptees’ outcomes.

Recalling positive autobiographical memories has been associated with various positive psychological outcomes, including enhanced mental well-being and self-efficacy. Given the known impact of stress on cognitive functioning, we investigated how momentary stress affects the repeated recall of selected autobiographical mastery memories (e.g., memories of overcoming challenges) in a training to enhance self-efficacy. During this one-week digital training, participants (N = 54) were asked to recall mastery memories, and we assessed their momentary stress levels, memory vividness, and recall feasibility using Ecological Momentary Assessment. Analyses using linear mixed-effects models showed that participants reported greater difficulty and less vividness in recalling self-efficacy memories during moments of increased stress, whereas feeling relaxed facilitated recall feasibility and vividness. Though participants who experienced less recall difficulty appeared to benefit more, recall difficulty and vividness did not significantly moderate improvements in self-efficacy. While replication in a larger, more diverse sample is indicated, our findings underscore the importance of considering momentary affect in memory-based mental health interventions. Effects may be particularly pronounced when interventions are applied during the early stages of stress, when stress levels are still relatively low, aligning with the strategy of Just-in-Time Adaptive Interventions. Our study also highlights the potential benefits of combining memory recall practices with relaxation-promoting interventions to enhance mental health outcomes.

Aims Although natural hazards (e.g., tropical cyclones, earthquakes) disproportionately affect developing countries, most research on their mental health impact has been conducted in high-income countries. We aimed to summarize prevalences of mental disorders in Global South populations (classified according to the United Nations Human Development Index) affected by natural hazards. Methods To identify eligible studies for this meta-analysis, we searched MEDLINE, PsycINFO and Web of Science up to February 13, 2024, for observational studies with a cross-sectional or longitudinal design that reported on at least 100 adult survivors of natural hazards in a Global South population and assessed mental disorders with a validated instrument at least 1 month after onset of the hazard. Main outcomes were the short- and long-term prevalence estimates of mental disorders. The project was registered on the International Prospective Register of Systematic Reviews (CRD42023396622). Results We included 77 reports of 75 cross-sectional studies (six included a non-exposed control group) comprising 82,400 individuals. We found high prevalence estimates for post-traumatic stress disorder (PTSD) in the general population (26.0% [95% CI 18.5–36.3]; I ² = 99.0%) and depression (21.7% [95% CI 10.5–39.6]; I ² = 99.2%) during the first year following the event, with similar prevalences observed thereafter (i.e., 26.0% and 23.4%, respectively). Results were similar for regions with vs. without recent armed conflict. In displaced samples, the estimated prevalence for PTSD was 46.5% (95% CI 39.0–54.2; k = 6; I ² = 93.3). We furthermore found higher symptom severity in exposed, versus unexposed, individuals. Data on other disorders were scarce, apart from short-term prevalence estimates of generalised anxiety disorder (15.9% [95% CI 4.7–42.0]; I ² = 99.4). Conclusions Global South populations exposed to natural hazards report a substantial burden of mental disease. These findings require further attention and action in terms of implementation of mental health policies and low-threshold interventions in the Global South in the aftermath of natural hazards. However, to accurately quantify the true extent of this public health challenge, we need more rigorous, well-designed epidemiological studies across diverse regions. This will enable informed decision making and resource allocation for those in need.

This essay takes its point of departure from Mark Solms' contention that Freud's neurological thinking informs his work throughout, and that the RSE renders this more thoroughly than the SE. Starting from this contention I examine and compare the RSE and the SE on the question Freud's theorization of difference from his neurological writings onward. I pay special attention to the subtle distinction in the original German of Freud's uses of Unterschied (difference between) and Differenz (difference).

Language is a productive system––we routinely produce well-formed utterances that we have never heard before. It is, however, difficult to assess when children first achieve linguistic productivity simply because we rarely know all the utterances a child has experienced. The onset of linguistic productivity has been at the heart of a long-standing theoretical question in language acquisition––do children come to language learning with abstract categories that they deploy from the earliest moments of acquisition? We address the problem of when linguistic productivity begins by marrying longitudinal behavioral observations and computational modeling to capitalize on the strengths of each. We used behavioral data to assess when a sample of 64 English-learning children began to productively combine determiners and nouns, a linguistic construction previously used to address this theoretical question. After the onset of productivity, the children produced determiner–noun combinations that were not attested in our sample of their linguistic input from caregivers. We used computational techniques to model the onsets and trajectories of determiner–noun combinations in these 64 children, as well as characteristics of their utterances in which the determiner was omitted. Because we knew exactly what input the model was trained on, we could, with confidence, know that the model had gone beyond its input. The parallels found between child and model in the timing and number of novel combinations suggest that the children too were creatively going beyond their input.

Negative rumination and emotion regulation difficulties have been consistently linked with depression. Despite anhedonia—the lack of interest in pleasurable experiences—being a cardinal symptom of depression, emotion regulation of positive emotions, including dampening, are considered far less in the literature. Given that anhedonia may manifest through blunted responses to previously positive or enjoyable experiences, it is vital to understand how different positive emotion regulation strategies impact anhedonia symptom severity and how it can vary or change over time. Moreover, understanding the detrimental or protective nature of positive emotion regulation on anhedonia can aid with future anhedonia-focused treatments. Therefore, the current study examined the temporal association between anhedonia dynamics and two different emotion rumination strategies in response to positive emotions: dampening and positive rumination. Depressed persons (N = 137) completed baseline measures of positive emotion regulation, difficulties regulating negative emotions, and anxiety, and completed ecological momentary assessments three times per day for 90 days regarding their depressive symptoms, including anhedonia. We assessed baseline dampening and amplifying scores to predict anhedonia dynamics through four linear models with interactions. Providing partial support for our hypotheses, results indicate that amplifying positivity is positively associated with fluctuations, instability, and acute changes in anhedonia over the course of 90 days; however, neither dampening, difficulties regulating negative emotions, nor anxiety were related to anhedonia dynamics. The current findings suggest that amplifying positivity may be able to predict changes in anhedonia over time and should further be examined as a potential protective factor of anhedonia.

Objective Self-efficacy is associated with positive mental health outcomes. We developed and tested a digital self-efficacy training for daily recall of autobiographical self-efficacy memories (e.g., memories of successfully overcoming a personal challenge). Method In this randomized controlled trial, we investigated the effects of the week-long digital self-efficacy training on key mental health outcomes, including anxiety, stress, and hopelessness, and on self-efficacy in 93 university students (mean age 23.3 years, SD: 3.49) with elevated self-reported stress levels. Participants completed either the self-efficacy training combined with ecological momentary assessment (EMA) (training group) or EMA only (control group). Results We found significantly reduced hopelessness and trait anxiety in the training group compared to the control group at post-assessment (one day post intervention). Effects on ratings of self-efficacy at post-assessment were also significant when controlling for baseline self-efficacy. Conclusions This stand-alone digital self-efficacy training was significantly associated with a number of positive effects on outcomes compared to a control condition, including reduced hopelessness, trait anxiety, and increased self-efficacy. Future work is needed to replicate and investigate the long-term effects of the training and explore its implementation in clinical populations. Trial registration ClinicalTrials.gov Identifier: NCT05617248

The VIPP-SD (Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline) program has been shown to promote positive interactions between parents and children with behavior problems. This study evaluated an adapted version for teachers (VIPP-School) through a parallel-group randomized controlled trial involving 58 teacher-child dyads from kindergarten to second grade. Teacher-child dyads were randomly assigned to VIPP-School (n = 28) or an active control group (n = 30). Intention-to-treat analyses showed improvements in teacher sensitivity (d = 0.87) and supportive teacher classroom interactions (d = 0.53) in the VIPP-School condition compared to the control condition. VIPP-School had no significant effect on teachers' observed sensitive discipline (although changes were in the expected direction), nor on reported child externalizing behavior, overall relationship quality, school happiness or teacher self-efficacy. These findings show that the intervention, originally developed for families, could be effectively applied to early elementary education. The limited number of sessions increases the feasibility of VIPP-School.

Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.

This contribution to a symposium on Samantha Frost’s Lessons From a Materialist Thinker discusses its groundbreaking approach to Hobbes’s thought and raises two questions that are still to be answered by future scholars: what does a materialist politics or a materialist ethics look like, and how can we understand juridical relations from a materialist standpoint?